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Who?

Patients with cancer and symptoms of depression, and the clinicians treating them.

What?

Screening cancer patients for symptoms of depression and treating their depression with a specially developed programme called ‘Depression Care for People with Cancer’ (DCPC).

Aims

To study the process of putting into action (implementing) a screening and treatment system for depression into the Oxford Cancer Centre.

To find out what steps are needed to introduce the system into Oxford Cancer Centre, how well it work for patients clinicians.

Why this is important

10% of cancer outpatients suffer from depression.

Depression can make symptoms such as pain and fatigue worse, reduces patients’ quality of life and makes it more difficult for them to cope with their cancer treatments. Despite its negative effects on people’s lives, we know that depression is often not recognised and treated in patients with cancer.

We have developed a system for identifying and treating depression in people with cancer.

The first step of this system is screening patients to identify those with symptoms of depression. To do this, all patients attending cancer outpatient clinics are asked about symptoms of depression by the Symptom Monitoring Service.

The second step is a treatment programme called ‘Depression Care for People with Cancer’ (DCPC). This combines both antidepressant medication and psychological treatment. DCPC is provided by a team of nurses and psychiatrists who work with patients’ GPs and oncologists.

We have tested DCPC in large clinical trials and found it to be both cost-effective and effective in reducing the symptoms of depression, and therefore increasing the patients’ quality of life.

We are now ready to introduce this new system in the Oxford Cancer Centre. We will do this in collaboration with Oxford University Hospitals NHS Foundation Trust’s Psychological Medicine service and Macmillan Cancer Support.

Methods

We will:

(a) Conduct interviews with patients and clinicians to learn about their experiences of the new system, analysing them for the main themes and concerns.

(b) Use logs, made at the time of an event, to record key events related to the introduction of the new system.

(c) Use routine clinical data and observation to understand how well the system works.

How this could benefit patients

The successful introduction of the new system in the Oxford Cancer Centre will help more than 3,000 cancer patients every year. Patients will take part in screening for depression, ensuring that diagnoses are not missed. They will also have access to high-quality treatment for depression that is integrated with their cancer care.

Findings from this study will be used to produce a toolkit which will help to introduce the system in other cancer centres.